A record share of US kindergartners had an exemption for required vaccinations last school year, leaving more than 125,000 new schoolchildren without coverage for at least one state-mandated vaccine, according to new data published Wednesday by the US Centers for Disease Control and Prevention. And another dip in measles vaccination rates among kindergartners means coverage has now been well below the federal target for four years in a row.
The US Department of Health and Human Services has set a goal that at least 95% of children in kindergarten will have gotten two doses of the measles-mumps-rubella (MMR) vaccine, a threshold necessary to help prevent outbreaks of the highly contagious disease.
After this rate was maintained for a decade, though, coverage dipped during the Covid-19 pandemic and has yet to recover. The measles vaccination rate fell again last year, to 92.7% coverage for kindergartners in the 2023-24 school year, according to the CDC data.
Rates for other state-mandated vaccinations – including diphtheria, tetanus and acellular pertussis, known as DTaP, and polio – also declined.
“Public health officials are concerned about decreased vaccination rates in Kindergarteners. Childhood vaccines are safe and effective and have made a profound difference in reducing suffering and death from what were once dreaded infectious diseases,” Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials, said in a statement.
The rate of vaccine exemptions for children has risen as coverage rates have declined in recent years; last school year, vaccine exemptions reached the highest level ever reported in the US. About 3.3% of kindergartners had an exemption for one or more required vaccines, CDC data shows, and the vast majority were nonmedical exemptions.
Local health officials are concerned about decreased vaccination coverage among US kindergarteners and what it could mean for public health risks, said Lori Tremmel Freeman, chief executive officer for the National Association of County and City Health Officials.
“The broader story is that vaccination coverage decreased in 35 states, and 14 states out of those 35 had at least one full percentage point drop, and what that translates to is about 280,000 students without proof of complete vaccinations,” Freeman said.
“But the more you consider local communities and neighborhoods, the more the risk can be different, because you see these larger pockets of vaccine-hesitant communities,” she said. “We often see congregations of the same people together in these communities, and disease can spread rapidly because they all have similar beliefs.”
In communities where vaccination coverage lags, it can create an opportune environment for illnesses to spread. Some local health departments already have seen outbreaks of infectious diseases in pockets of communities with low vaccination rates, Freeman said.
There was a measles outbreak this year in Chicago, where at least 57 cases were connected to a migrant shelter. And an outbreak at an elementary school in Florida’s Broward County led a lawmaker to call for a public health emergency.
More than two dozen states reported measles infections in early 2024. By March, there had been more reported cases for the year than there were in all of 2023, according to CDC data.
The CDC has warned that a rapid rise in cases nationally — significantly more than in recent years — poses a renewed threat to the country’s disease elimination status.
Measles vaccination coverage among kindergartners varies widely by state, but only about a dozen states met the federal target of 95% for measles vaccination among kindergartners, according to the new CDC data.
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“While it’s encouraging to know that more than 9 out of every 10 children ARE receiving their recommended vaccines, the seemingly small decreases (from 93.1% MMR vaccine coverage to 92.7% coverage, for example) can have an outsized negative impact,” Amy Pisani, chief executive officer of Vaccinate Your Family, a nonprofit advocacy organization, said in a statement. “These data points matter because each drop in coverage places all our children at increasing risk of serious infectious diseases that were once a thing of the past.”
Measles is a highly contagious airborne disease. It can cause serious health consequences or death, especially for young and unvaccinated children.
General symptoms may include fever, cough, runny nose, watery eyes and a rash of red spots. About 1 in 5 unvaccinated people in the US who get measles will be hospitalized, according to the CDC. About 1 in every 20 children will develop pneumonia, and others may develop a dangerous swelling in the brain called encephalitis. Up to 3 of every 1,000 children who become infected with measles may die from respiratory and neurologic complications.